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What Is the Bipolar Spectrum?

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Overlapping Symptoms of Bipolar Spectrum Conditions and Bipolar Disorder

Many people with mental conditions other than bipolar disorder experience symptoms of bipolar disorder. For example, many people with borderline personality disorder experience depression along with severe mood swings and problems with impulse control.

Although these people do not meet the diagnostic criteria for bipolar disorder, some psychiatrists believe they have something important in common with people with bipolar disorder.

Symptoms that may overlap between bipolar spectrum conditions and bipolar disorder include:

  • Depression with very sudden or frequent mood swings (seen in many mental conditions)
  • Prolonged irritability (possibly a form of mania)
  • Impulsivity (common during manic episodes)
  • Euphoria and high energy (common in substance abusers)

Because the cause of bipolar disorder isn't known, it's difficult for experts to know the real overlap between bipolar spectrum and bipolar disorder.

Treatment of Bipolar Spectrum Disorders

Another argument for considering non-bipolar-disorder conditions to be on the bipolar spectrum is for purposes of treatment. Psychiatrists have long known that mood stabilizers, such as lithium, may be effective to some degree in people with conditions other than bipolar disorder. That includes conditions such as major depressive disorder, impulse control disorders, or some personality disorders.

Psychiatrists may sometimes prescribe bipolar disorder treatments for people believed to have bipolar spectrum disorders. Examples include:

In bipolar spectrum conditions, these mood stabilizers are generally used as add-on therapies after treating the main mental condition. Some experts question the appropriateness of the widespread use of these medicines for people without bipolar disorder.

 

Bipolar Spectrum Disorders: M, m, D, d

Like other areas of medicine, psychiatry is constantly undergoing changes in the face of new treatments and new ideas. 

The basic concept of a bipolar spectrum is more than a century old, having been proposed by the original founders of modern psychiatry. It gained new life in the 1970s after a leading psychiatrist proposed classifying mood symptoms as follows: 

  • Upper-case "M": Episodes of full-blown mania
  • Lower-case "m": Episodes of mild mania (hypomania)
  • Upper-case "D": Major depressive episodes
  • Lower-case "d": Less-severe symptoms of depression 

Under this classification, people would be described by the combination of their manic and depressive symptoms. This system has not entered wide use, however. This past decade has been a period of renewed interest by some psychiatrists in exploring whether the bipolar spectrum may exist as a scientifically valid diagnostic concept. Whether a bipolar spectrum exists and how important it might be continue to be examined by researchers and, meanwhile, debated among psychiatrists.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on March 28, 2013
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